The purpose of the project is to determine the relationship of maternal diabetes and other early developmental factors to later risk of metabolic disease. The risk of early onset obesity and type 2 diabetes is greatly increased in offspring exposed to maternal diabetes in utero. This exposure also results in slower growth in weight relative to height during the first year and a half of life, with an accelerated gain in weight relative to height later in childhood. Continuing recruitment of young Pima Indians in the longitudinal study will help elucidate effects of maternal diabetes, birth weight, and early growth on risks of obesity and diabetes in adolescents and young adults. Recent analyses of the long-term follow-up data indicate that glucose intolerance in pregnancy, even at levels not diagnostic of diabetes, increases long-term risk of diabetes to the child.